Losing Faith!!

The Health Service Executive (HSE) is making headlines again but then what's new. It's so frustrating that nothing has changed in the six years since I moved back to Ireland.

The optimists among us would probably say that we just have to find a new way to show the rule makers that they need to change the way they do things. We, the advocates and activists, have to constantly change our methods yet the rule makers don't. Why can't we just launch a rolled up piece of paper from a rubber band into their faces and say "WAKE UP!' Oh yeah, that's been outlawed:-(

I'm exhausted from all the changing... and I don't even do that much to advocate apart from raise my voice or send an email when I'm asked. I can't imagine how frustrated the guys are that actually have to sit down and negotiate with this crowd and make nice with them.

I'm so fed up of hearing about how inefficient and under-resourced the health service is in Ireland. It's been that way for decades! I'm fed up of hearing how it's the minister's fault!  I'm fed up of the HSE blaming the department of Health! I'm fed up of the minister making promises and then being stonewalled when trying to deliver those promises. I'm fed up hearing about negotiations with unions when efforts are being made to improve working conditions; a better service means happier workers. I'm fed up hearing about how the HSE staff can't change anything because of the hiring freeze! All we hear from them is "I can't".

Well people, I think it's time some of you read "The little engine that could".

Is it really that difficult to straighten out a health service? Is it rocket science? Is it really about lack of money?

I'm not asking for a perfect system here, just one that works reasonable well.

People of the HSE, all of you, stop blaming each other and fighting with each other! GET THE JOB DONE AND STRAIGHTEN IT OUT!!!

Carb Counting

At our last Type 1 diabetes support group meeting we talked about carbohydrate counting, commonly referred to as carb counting.

The group was made up of people who practiced carb counting, people who kind of practiced, people who knew about it but didn't know where to start and some who never heard of it. We were a motley crew.

The topic was introduced by stating that carb counting has been around for a long time in one form or another. When I was diagnosed in 1993 I was introduced to the Exchange List. This was a list of commonly eaten foods such as bread, weetabix, that contained roughly the same amount of carb. For example 1 slice of bread contained approximately 15 grams of carb as did 1 weetabix. The idea was that if you had weetabix for breakfast in the mornings and fancied a change you could switch it for toast.

In today's world we can do carb counting by either weighing our food in grams or using the unit Carb Portion (CP). It's a bit more precise than the exchange list.

We, then, discussed today's methods of carb counting and what exactly it is. "Carbohydrate counting is a method of matching your insulin requirements with the amount of carbohydrate you eat and drink."

If you take insulin, you can use carbohydrate counting to decide how much insulin to take.

The benefits that carb counting can give you are:

· May lead to better blood glucose control and greater flexibility and freedom of lifestyle.

· May be able to predict your blood glucose response to eating different foods and drinks.

· Eat according to your appetite.

· Enjoy a wider variety of foods.

· Enjoy restaurant and takeaway meals.

 

The only disadvantage to carb counting the group came up with was that you really have to put great deal of time and effort to get those benefits.

Where do I learn more if you live in the Mid-West?
 

· The dietitian at your clinic or any registered dietitian who is knowledgable in Type 1 Diabetes.
 

· DAFNE (Dose Adjustment For Normal Eating) courses http://www.dafneonline.co.uk/DAFNE is a structured education course delivered in a five day intensive skills based education programme to people with Type 1 Diabetes. In this course, people learn how to adjust their insulin dosage to suit their free choice of food, rather than having to work their life around their insulin doses. DAFNE aims to encourage and equip people who have Type 1 diabetes to manage their insulin regimens actively and independently. This course is available only to patients who attend the Diabetes clinic in University Hospital Galway.
 

· BERGER course The Berger Programme is a comprehensive diabetes self-care skills course, named after Professor Michael Berger, the eminent Endocrinologist who recognised the value of teaching people how to adjust insulin to match their daily food intake. This programme is designed for people with Type 1 diabetes. People attending this course learn how to adjust their insulin dose depending on their food choice. The course also focuses on enhancing diabetes self-management skills. This course is run in St. John’s Hospital Limerick 061/462271
 

· BRUCIE - Better Regulation Using Carbohydrate and Insulin Education BRUCIE is an education programme aimed at providing adolescents over 12 years with diabetes the skills to understand the relationship between food, blood results and insulin dose adjustments. The workshop is based on developing practical skills and involves gaining a greater understanding of the effect of diet on their blood glucose levels. Education sessions on carbohydrate counting are also provided for parents of adolescents who attend BRUCIE. A joint session with adolescents and parents is provided at the yearly follow up. BRUCIE is delivered by the diabetes Dietitian and the Advanced Nurse Practitioner in diabetes. This course is available to patients who attend the Diabetes clinic in University Hospital Galway.
 

· Private Carb Counting Course by Kelly Johnson. The cost of the course is €150 for two full days. Contact information: mobile number: 086 8117676. She is hoping to run a course on 29^th Sept and the 6^thOctober.

 

If you don't live in the Mid West you can find out about carb counting courses from your diabetes clinic or from the DAFNE website.

 

Weighed down by weight issues

I'm getting old! Yep, I'm having that life crisis that happens to even the most optimistc of us as we approach those birthdays that end in zero.

Anyway, this summer when I was trying to squease into the seasonal outfits I thought to myself, "why not just tackle that stone or two once and for all". Wishing for it to happen doesn't make it happen, does it?

My diet is fairly decent; it does have some flaws but nothing catastrophic. I've always trimmed out the fat except for my little treat after my dinner every day which I will not give up! Never! So where the calorie intake is concerned I've decided to cut down on portion sizes and increase portions of salads and veggies.

My next step is to review my calorie output. Exercise! Auck! I already do a 30 minute brisk walk Monday through Friday. So in an effort to add to that I delved into "The I hate to exercise" book for people with diabetes to look for inspiration.

Now this book has been sitting on my shelf untouched for about 18 months. And if I'm honest the other reason I picked it up was because the previous book I read was so good that I would stay up until the wee hours reading (I needed some sleep).

I open it  and the first line is "well done, you've opened the book". At first, I laughed and patted myself on the back but when I thought about why I was reading it, I stopped laughing. I felt a bit ashamed but then I decided to laugh again. Why not?

So, well done me! I read the whole book. Surprise, surprise. there were no magic cures or quick fixes contained in it because there are none with weight loss. The book was really not targeted at me. It's really written for people who have not included exercise in their lives and may be more advanced in age.

My new next step is to carry on with my reduced carb portions and my 30 minute walk from now til December. Live life as best I can and not to get so weighed down (pun intended). I'll let you know if it works. I will say my blood sugar readings are looking very good with these reduced portions. One step/one day at a time:-)